Symposia
Dissemination & Implementation Science
Giovanni Ramos, M.A.
University of California Los Angeles
Los Angeles, California
Lauren Brookman-Frazee, Ph.D.
Professor
University of California, San Diego
San Diego, California
Tamar Kodish, M.A.
Clinical Psychology PhD Student
University of California Los Angeles
Santa Monica, CA
Adriana Rodriguez, PhD
-
Children and Youth Behavioral Health, Health Care Agency
Los Angeles, California
Anna S. Lau, Ph.D.
Professor
UCLA
Los Angeles, California
Examining therapists’ experiences implementing evidence-based practices (EBPs) is fundamental to understanding how these interventions are adapted and used when serving racial and ethnic minoritized youth and their families. However, little is known about racial/ethnic variation in therapists’ experiences. Through a QUAN qual QUAN mixed-methods approach, we examined differences in self-reported therapists’ adaptations performed and client-engagement challenges in the largest county-operated department of mental health in the United States. Therapists (n = 743; Latinx [44%], White [34%], Other Ethnic Minority [22%]) were mostly female (88%), master’s level (85%), and unlicensed (58%). These providers completed the Adaptations to Evidence-Based Practices Scale and the Perceived Client Engagement Challenges scale. A subset of therapists (n = 60) completed in-depth semi-structured interviews regarding their EBP implementation experiences. Quantitative differences across groups were tested using a multivariate analysis of covariance (MANCOVA). Statistically significant multivariate tests were followed by multiple analysis of covariance (ANCOVA) with Bonferroni correction. Qualitative analyses followed a stepwise methodology of consensus, co-occurrence, and comparison to identify qualitative themes that potentially mapped onto significant quantitative results. Finally, prominent themes were used to identify potential quantitative variables that could refine a new statistical model for further analyses. Latinx therapists reported more making more adaptations to EBPs and encountering fewer client-engagement challenges than White and Other Ethnic Minority Therapists. Qualitative analyses expanded on these results, revealing that Latinx therapists commonly described adapting EBPs in terms of language and culture to improve fit and promote client engagement. Informed by these qualitative themes, a refined statistical model revealed that the ability to deliver EBPs in another language might have accounted for differences in therapist-reported EBP adaptations and client- engagement challenges. Findings suggest that racial/ethnic minoritized therapists are able to successfully adapt and use EBPs when serving families of color in community settings. In the case of Latinx therapists, bilingual/bicultural competence may facilitate adapting EBPs in ways that reduce perceptions of engagement challenges with racially/ethnically marginalized clients.